March is National Colorectal Cancer Awareness Month

The goal of the annual National Colorectal Cancer Awareness Month is to make people aware of colorectal cancer and to encourage people to learn more about how to reduce their risk of colorectal cancer (CRC) through regular screening and a healthy lifestyle. The results of the National Health Interview Survey (NHIS) administered to 32,374 adults 18 years of age or older in 2000 showed that colorectal cancer screening is underused [1]. Just over 60% of adults had ever had colorectal cancer testing. Only 44% of men and 37% of women greater than 75 years of age were current for testing. Colorectal cancer screening is very important. If colorectal cancer is allowed to metastasize (meaning to spread to other parts of the body), the 5-year survival rate is less than 10%. However, if colorectal cancer is found early, the 5-year survival rate is greater than 90% [2].

Colorectal cancer can be prevented. Colorectal cancer starts in the digestive system and begins as a polyp. Polyps are small growths of tissue that start in the lining and grow in to the center of the colon or rectum. A specific type of polyp, an adenoma, can become cancerous. Screening for colorectal cancer can identify polyps and they can be removed to prevent cancer from ever occurring. Starting at age 50, men and women who are at average risk for colorectal cancer should get screened. Men and women who have a higher risk of the disease may need to be tested earlier and should talk to their health care professional about when. Colorectal cancer incidence rates are also increasing among people younger that 50 years of age. Indeed, colorectal cancer is ranked among the top 10 cancers occurring in males and females aged 20-49 years regardless of race [3]. No matter what your age, know the risk factors, the symptoms and your family history.

Not counting skin cancers, colorectal cancer is the third most common cancer in the U.S. [4]. However, death due to colorectal cancer is declining. Much of the credit for a decrease in the death rate from colorectal cancer in 2004 has been attributed to screening exams and the early detection of polyps that can be removed before they become cancerous.

The exact cause of most colorectal cancers is unknown. However, there are a number of risk factors.

Age: The chance of having colorectal cancer increases after age 50. However, colorectal cancer incidence rates are increasing among persons younger than 50 years of age [3].

Prior occurrence of colorectal cancer: The likelihood of having colorectal cancer is increased if you have a previous history of colorectal cancer.

Prior history of polyps: Specific types of polyps increase the risk of colorectal cancer.

History of bowel disease: Ulcerative colitis and Crohn’s disease, diseases that involve inflammation of the colon over a long period of time, increase the risk of colon cancer.

Family history of colorectal cancer: Risk of colorectal cancer is increased if you have relatives that have had this cancer. Twenty percent of individuals diagnosed with colorectal cancer have a first- or second-degree relative with the disease.

Genetic factors: Familial adenomatous polyposis (FAP) is an inherited condition in which numerous polyps form in the large intestine. Malignant transformation occurs 100% of the time if left untreated.

Race: African Americans have the highest rate of colorectal cancer and the highest death rate from colorectal cancer of all racial groups in the United States. The reason for this is not known.

Diet: A diet high in saturated fat can increase the risk of colorectal cancer. Consumption of red meats [4] and processed meats [6] can also increase colorectal cancer risk.

Lack of exercise: According to the American Cancer Society (ACS), regular physical activity reduces the risk of colorectal cancer as well as breast and possibly other cancers, and also reduces the risk of cardiovascular disease and diabetes.

Overweight: Being overweight at diagnosis is associated with an increased risk for recurrence of and death from colon cancer [7].